There are medications that take the fatigue away. I forget the name but they are prescription medications that turn off the fatigue in your brain.
Modafinil/Provigil? I recently started taking this (prescribed by my pulmonologist for excessive daytime sleepiness). It was great the first week then it's effectiveness lessened dramatically, but it's still enough that I can function more effectively at work than before. My new rheumy seemed surprised I was taking it; she didn't tell me to stop but it sounds like I'll be starting a biologic sometime this fall (after recovering from surgery) so perhaps then she'll suggest I cease and see if the biologic helps with the fatigue/sleepiness.